TEAMWORK, COMMUNICATION AND DECISION-MAKING: AN ASSESSMENT PROGRAM USING SIMULATI

描述（由申请人提供）：团队合作，沟通和决策：使用模拟危机的评估程序在医疗中心的事件通常由一个专家团队管理，团队成员同步他们的努力，以确保最佳的病人护理。成功的结果不仅取决于团队成员的技能，还取决于他们相互沟通和共同达成诊断和治疗计划的能力。到目前为止，很少有调查系统地考虑了危机事件团队的沟通模式，很少有人考虑了他们的决策过程，我们所知道的没有一个将两者联系起来。我们建议使用模拟来比较和对比的沟通模式和决策过程中的两个团队，在危机中作出反应：儿科快速反应小组和创伤复苏队。每个团队都将遇到遵循公认模式的模拟，以及需要团队重新评估和重新评估非典型且不遵循常规的条件的场景。我们的目标是确定那些构成有效沟通的行为，以及那些导致有效决策的认知和沟通行为。我们还将考虑沟通和决策如何相互关联，以及医疗团队如何识别和纠正诊断学驱动的诊断错误。30个儿科团队和30个创伤团队将参加9个模拟场景，这些场景将代表一系列危机事件。每个小组将由三名住院医生和一名护士组成（即，一个脚本的同盟者）。每个小组的沟通模式将使用定性技术从会话分析和定量技术使用计算机软件包称为DYALOGUE研究。决策的敏锐性和团队合作的质量将通过专家小组填写的清单进行评估。我们预测，成功的团队从事可比的沟通和决策行为，无论是什么类型的团队。这项调查汇集了麻醉学，外科，护理，听力康复和心理测量学领域的专家，将产生必要的数据和方法，用于制定教学和评估策略，以培训团队沟通和决策，在美国各地的医疗中心。 公共卫生相关性：项目描述-两种类型的危机医疗团队将参与模拟场景，以确定什么是有效的沟通和决策过程，并确定团队如何避免医疗驱动的诊断错误。结果将导致全国范围内更好的病人护理，因为我们的目标是为未来的医疗团队成员开发数据驱动的评估和培训程序。

DESCRIPTION (provided by applicant): Teamwork, Communication and Decision-Making: An Assessment Program Using Simulation Crises events in medical centers are typically managed by a team of experts, with team members synchronizing their efforts to ensure optimal patient care. Successful outcomes hinge not only upon the skills of the team members, but also upon their abilities to communicate with one another and to collectively reach a diagnosis and treatment plan. To date, few investigations have systematically considered the communication patterns of crisis event teams and few have considered their decision-making processes, and none that we know of have related the two. We propose to use simulation to compare and contrast the communication patterns and decision-making processes of two teams that respond in crisis: pediatric rapid response teams and trauma resuscitation teams. Each team will encounter simulations that follow recognized patterns as well as scenarios that require teams to reassess and reevaluate a condition that is atypical and does not follow usual heuristics. Our goal is to identify those behaviors that comprise effective communication, and those cognitive and communicative actions that lead to effective decision-making. We will also consider how communication and decision-making inter-relate, and how medical teams recognize and correct heuristics-driven diagnostic mistakes. Thirty pediatric teams and thirty trauma teams will participate in nine simulation scenarios, scenarios that will represent a range of crises events. Each team will consist of three resident physicians and one staff nurse (i.e., a scripted confederate). Each team's communication patterns will be studied using qualitative techniques from Conversational Analysis and quantitative techniques using a computer software package called DYALOGUE. Decision-making acumen and quality of teamwork will be assessed with checklists completed by panels of experts. We predict that successful teams engage in comparable communication and decision- making behaviors, regardless of the type of team. This investigation, which brings together experts in the fields of anesthesiology, surgery, nursing, aural rehabilitation, and psychometrics, will yield data and methodology necessary for developing teaching and assessment strategies for training team communication and decision making in medical centers throughout the United States. PUBLIC HEALTH RELEVANCE: Project Description - Two types of crisis medical teams will engage in simulation scenarios to determine what constitutes effective communication and decision-making processes and to determine how teams may avoid heuristics-driven diagnostic mistakes. Results will lead to better patient care nation-wide, as we aim to develop data-driven assessment and training procedures for future medical team members.